Penile Cancer

Overview: What Is Penile Cancer?

Penile cancer is a rare form of cancer that develops in the skin or tissues of the penis. While it accounts for less than 1% of cancers in men in the United States, it is more common in parts of Asia, Africa, and South America. Most cases occur in men over the age of 50, but it can develop at any age.

Although uncommon, penile cancer can have a significant emotional and physical impact on men. The good news is that when caught early, penile cancer is highly treatable. Early detection not only improves survival but also increases the chances of preserving normal sexual and urinary function.

What Are the Types of Penile Cancer?

Several types of penile cancer exist, depending on the cells involved:

• Squamous cell carcinoma (SCC): The most common type, accounting for about 95% of cases. It usually begins on the foreskin or glans (head of the penis).
• Basal cell carcinoma: Less common and generally grows slowly.
• Melanoma: A rare but aggressive cancer that begins in pigment-producing cells of the skin.
• Sarcoma: Extremely rare, starting in connective tissues like blood vessels or muscle.
• Adenocarcinoma: A rare cancer arising from sweat glands in the skin of the penis.

What Are the Causes of Penile Cancer?

The exact cause of penile cancer is not fully understood. However, changes in the DNA of penile cells can cause them to grow uncontrollably and form tumors. These changes may be triggered by factors such as:

• Human papillomavirus (HPV) infection: A common sexually transmitted infection strongly linked to penile cancer.
• Chronic inflammation or infection: Long-term irritation can damage cells.
• Poor hygiene: Especially in uncircumcised men who do not clean under the foreskin regularly.
• Tobacco use: Smoking introduces cancer-causing chemicals into the bloodstream.

What Are the Risk Factors for Penile Cancer?

Certain factors increase a man’s risk of developing penile cancer:

• Age: Most common in men over 50.
• HPV infection: Especially high-risk strains like HPV-16 and HPV-18.
• Lack of circumcision: Increases the likelihood of smegma buildup, which can cause irritation.
• Phimosis: A condition where the foreskin cannot be retracted, making hygiene difficult.
• Smoking: Raises the risk by damaging immune defenses and cell DNA.
• UV light treatment for psoriasis: Rarely, long-term exposure to ultraviolet light can increase risk.
• Family history: Though not a major factor, some genetic predispositions may exist.

What Are the Symptoms of Penile Cancer?

Recognizing early symptoms is critical. Common signs include:

• A growth, lump, or sore on the penis that does not heal within a few weeks.
• Changes in skin color or thickening of penile skin.
• Persistent redness, irritation, or a rash.
• A foul-smelling discharge under the foreskin.
• Bleeding from the penis or foreskin.
• Swelling at the tip of the penis.

Advanced symptoms may include:

• Pain in the penis.
• Enlarged lymph nodes in the groin.
• Difficulty urinating if the tumor blocks the urethra.

How Is Penile Cancer Diagnosed?

Doctors use several tests and procedures to diagnose penile cancer:

• Physical examination: Checking the penis for lumps, sores, or unusual skin changes.
• Biopsy: A small tissue sample is taken from the suspicious area and examined under a microscope. This confirms the diagnosis.
• Imaging tests: Ultrasound is done to check tumor depth. CT scan or MRI to see if cancer has spread to lymph nodes or other organs. PET scan is used in advanced cases to assess tumor spread.

Staging of Penile Cancer

Staging

Staging helps determine how far the cancer has spread:

• Stage 0: Cancer is only in the top layer of skin.
• Stage I: Cancer has grown deeper but not into lymph nodes.
• Stage II: Cancer has spread to deeper tissues of the penis.
• Stage III: Cancer has spread to nearby lymph nodes.
• Stage IV: Cancer has spread to distant organs.

Grading

Grading refers to how abnormal the cancer cells look under a microscope.

• Low-grade tumors look more like normal cells and grow slowly.
• High-grade tumors look very abnormal and grow more aggressively.

Both stage and grade guide doctors in choosing the best treatment plan.

What Are the Treatment Options for Penile Cancer?

Treatment depends on the cancer’s stage, grade, and location, as well as the patient’s overall health.

• Surgery:
  • Circumcision: Removal of the foreskin if cancer is confined there.
  • Wide local excision: Removing the tumor and some surrounding healthy tissue.
  • Mohs surgery: Layer-by-layer removal, preserving as much normal tissue as possible.
  • Partial penectomy: Removing part of the penis if cancer is more advanced.
  • Total penectomy: Removing the entire penis in severe cases. Reconstructive surgery may follow.
• Radiation Therapy: High-energy beams are used to kill cancer cells. External beam radiation is directed at the tumor. Brachytherapy involves placing radioactive material directly in the tumor area.
• Chemotherapy: Drugs are used to kill cancer cells. Topical chemotherapy creams may be applied for very early cancers. Systemic chemotherapy (IV or oral) is used for advanced stages.
• Targeted Therapy: Drugs that specifically attack cancer cells without harming normal cells. This is an emerging area of research in penile cancer.
• Immunotherapy: Helps the body’s immune system recognize and destroy cancer cells. It is being studied for advanced penile cancer cases.

What Is the Prognosis for Penile Cancer?

Survival depends on the stage at diagnosis:

• Early-stage (localized) cancer: 5-year survival rates can be 80–90%.
• If spread to nearby lymph nodes: Survival drops to around 50%.
• If spread to distant organs: Prognosis is less favorable, with survival rates around 10–20%.

Factors that affect prognosis include:

• Stage and grade of cancer.
• Patient’s age and general health.
• Response to treatment.

Screening and Prevention of Penile Cancer

There are no standard screening guidelines for penile cancer. However, prevention strategies include:

• Practicing good genital hygiene.
• Getting circumcised (especially at birth or in early childhood).
• Using protection during sexual activity to reduce HPV risk.
• Getting the HPV vaccine.
• Quitting smoking.
• Seeking medical help promptly for any penile changes.

For International Patients

People from around the world come to Apollo Hospitals for the treatment of penile cancer. Our international patient services team will guide you all the way from seeking the first virtual connect all the way to treatment in India and then returning home post treatment.

Services include:

• Medical opinions and scheduling
• Pre-arrival medical review of reports and imaging.
• Travel and logistics
• Assistance with visa invitation letters, airport transfers, and nearby accommodation options.
• Dedicated international patient coordinators to guide through each step.
• Language and cultural support
• Interpreter services in multiple languages.
• Clear, simple explanations at every stage with written care plans.
• Financial coordination
• Transparent treatment estimates and packages when possible.
• Support with international payment methods and insurance coordination.
• Continuity of care
• Shared records, imaging, and treatment summaries for home doctors.
• Telemedicine follow-ups for convenience after returning home.

About Apollo Proton Cancer Centre

Apollo Proton Cancer Centre (APCC) is the first proton therapy centre in India. APCC has a fully integrated treatment suite that offers the most advanced treatment in surgical, radiation and medical oncology procedures. True to the Apollo Pillars of Expertise and Excellence, the Centre brings together a powerful team of clinicians renowned globally for cancer care.

At Apollo Proton Cancer Centre (APCC), we combine advanced technology with globally renowned clinical expertise to deliver superior outcomes and improved quality of life to our patients.